Account Representative - Houston Methodist Hospital
(2024-09)
- Collaborated with clinical and insurance teams to define project scope, ensuring that timelines and objectives were clearly set for authorizations, insurance verification, and patient access.
- Served as a liaison between internal stakeholders, including clinical staff and patients, to manage expectations and deliver timely results. Provided regular status updates and escalated issues when necessary.
- Identified potential barriers in the insurance verification and claim resolution processes and worked proactively with the team to implement solutions, ensuring successful project outcomes.
- Prepared and communicated detailed reports to leadership, offering data-driven insights and ensuring that all processes were aligned with strategic goals.
- Led initiatives to improve workflows in registration and billing, tracking performance and delivering actionable data to improve team efficiency and reduce account aging.
Insurance Biller - Houston Methodist Hospital
(2023-01 - 2024-09)
- Managed the timely submission of insurance claims, working to reduce project delays by adhering to strict deadlines and ensuring high-quality claim submissions.
- Utilized advanced Excel functions to track and report billing metrics, ensuring accuracy in financial data and improving reporting efficiency for project tracking.
- Coordinated between departments to resolve claim denials and issues, ensuring seamless communication and alignment with organizational goals.
- Assisted in training new staff, ensuring they were equipped with the knowledge to manage claims and billing processes effectively, contributing to overall project success.
Account Receivable Specialist - Hillcroft Medical Clinic
(2022-07 - 2023-01)
- Served as the key point of contact between patients, providers, and payers, ensuring that all parties were aligned and informed of project progress.
- Leveraged Excel to analyze performance metrics and support strategic decisions regarding billing and revenue cycle management.
- Identified and resolved recurring claim issues, ensuring that processes were continuously optimized and that potential barriers were mitigated proactively.
Claims Analyst - Association Health Care Management
(2021-09 - 2022-07)
- Monitored project milestones and delivered comprehensive analysis on insurance claims and denial rates to ensure that financial outcomes were in line with expectations.
- Assisted with the identification of project barriers related to insurance claims, providing solutions and guidance to leadership for smoother execution.
- Contributed to strategic initiatives that streamlined revenue cycle processes, improving quality outcomes and reducing operational costs.
Billing Specialist - Hillcroft Medical Clinic
(2016-03 - 2017-03)
- Determined claim compensability and communicated claim status to patients and payers via written correspondence and email.
- Managed payment posting, claim denials, and adjustments to ensure accurate patient account balances.
- Collaborated with physicians to resolve claim issues and provided education on payer requirements.
- Submitted claims through clearinghouse systems, ensuring timely and accurate billing.
- Verified authorizations and eligibility for services, including physician fees and hospital procedures.
- Processed both primary and secondary HFCA claims accurately.
- Applied CPT and ICD-10 coding standards to support billing accuracy.
- Maintained patient accounts and assisted with inquiries related to billing.
- Leveraged advanced Excel functions (pivot tables and conditional formatting) to analyze provider performance metrics, streamline revenue cycle reporting, and support strategic decision-making.
Billing Specialist - Healix
(2015-03 - 2016-03)
- Processed daily infusion therapy claims, ensuring compliance with coding and billing protocols.
- Conducted thorough claims reviews and provided timely follow-ups to resolve outstanding issues.
- Performed end-of-month audits to verify billing accuracy and completeness.
- Gained experience in multi-specialty billing, applying appropriate modifiers based on medical record review.
